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Ind Health. 2013;51(4):406-16. Epub 2013 May 22.

Job strain, sleep and alertness in shift working health care professionals -- a field study.

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Finnish Institute of Occupational Health, Finland.


We explored the associations of job strain with sleep and alertness of shift working female nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants' own job strain was at least as high in high-strain group or low in low-strain group as the ward's average. The study included three-week measurements with sleep diary and actigraphy. Psychomotor Vigilance Test (PVT) was performed during one pre-selected morning and night shift and a day off. Sleep efficiency before morning shifts was lower in the high-strain than low-strain group (p=0.03). Low-strain group took more often (72 vs. 45%; p<0.01) and longer naps (62 vs. 35 min; p=0.01) before the first night shift than high-strain group. Difficulties initiating sleep were more common in high-strain group, especially after evening shifts (p<0.01). High-strain group had more often at least one lapse in PVT during the night shift (p=0.02). Average sleep duration (06:49 h) and efficiency (89%) did not differ between these groups. In conclusion, high job strain is associated with difficulties initiating sleep and reduced psychomotor vigilance in night shifts. Shift working contributed to impaired sleep in both high and low job strain group. Individual and organization-based actions are needed to promote sufficient sleep in shift working nurses, especially with high job strain.

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